APPLICATION FOR EMPLOYMENT

NOTE: A SEPARATE APPLICATION MUST BE SUBMITTED FOR EACH POSITION

LAST NAME: / FIRST NAME: / MI
/ UMBC
AN HONORS UNIVERSITY IN MARYLAND
DEPARTMENT OF HUMAN RESOURCES
532 ADMINISTRATION
1000 HILLTOP CIRCLE
BALTIMORE, MD 21250
AN EQUAL OPPORTUNITY/ AFFIRMATIVE ACTION EMPLOYER
ADDRESS:
CITY: / STATE: / ZIP:
IF NOT A U.S. CITIZEN, INDICATE VISA
CLASS AND NUMBER / PHONE NUMBERS:
HOME:
CELL:
BUSINESS:
DO YOU LIVE ON CAMPUS OR OFF CAMPUS: / EMAIL ADDRESS / INDICATE POSITION:
CASHIER STOCKPERSON
YUM SHOPPE
COMPUTER DEPARTMENT
What Year Are you In?

EMPLOYMENT RECORD: BEGIN WITH YOUR CURRENT OR MOST RECENT POSITION AND WORK BACKWARD. INCLUDE VOLUNTEER WORK

WHICH WILL BE CREDITED AS PAID EXPERIENCE. INCOMPLETE APPLICATIONS ARE UNACCEPTABLE. IF YOU NEED MORE SPACE ATTACH A

CONTINUATION SHEET.

EMPLOYER / EMPLOYED
FROM TO / YOUR DUTIES AND RESPONSIBILITIES:
ADDRESS
TELEPHONE / MO / YR / MO / YR
YOUR TITLE
NAME & TITLE OF SUPERVISOR / BASE SALARY
REASON FOR LEAVING Select OneCurrently employedResignationLayoffTermination
EXPLAIN:
FIRST
$ / LAST
$
EMPLOYER / EMPLOYED
FROM TO / YOUR DUTIES AND RESPONSIBILITIES:
ADDRESS
TELEPHONE / MO / YR
/ MO / YR
YOUR TITLE
NAME & TITLE OF SUPERVISOR
BASE SALARY
REASON FOR LEAVING Select OneCurrently employedResignationLayoffTermination
EXPLAIN:
FIRST
$ / LAST
$
EMPLOYER / EMPLOYED
FROM TO / YOUR DUTIES AND RESPONSIBILITIES:
ADDRESS
TELEPHONE / MO / YR / MO / YR
YOUR TITLE
NAME & TITLE OF SUPERVISOR
BASE SALARY
REASON FOR LEAVING Select OneCurrently employedResignationLayoffTermination
EXPLAIN:
FIRST
$ / LAST
$

In compliance with the Safety and Security Act, UMBC provides employees and prospective employees upon request with a Security Report on university wide security and safety, including related policies, procedures and crime statistics. A copy of this report may be obtained by calling the UMBC Police Department at 410-455-3133.

IN ORDER TO BE HIRED INTO THE POSITION FOR WHICH YOU HAVE APPLIED, YOU MUST BE A CITIZEN OR NATIONAL OF THE UNITED

STATES OR AN ALIEN LAWFULLY ADMITTED FOR UNITED STATES PERMANENT RESIDENCE, OR ALIEN AUTHORIZED UNDER UNITED

STATES IMMIGRATION REFORM AND CONTROL ACT OF 1986

REVISED 04/09

SCHOOLS / NAMES AND ADDRESSES OF
SCHOOL / DID YOU
GRADUATE? / DATES FROM / TO / NUMBER OF YEARS
AND CREDIT HOURS
COMPLETED / MAJOR OR TYPE
OF PROGRAM / TYPE OF DEGREE OR
CERTIFICATION AND DATE RECEIVED
HIGH SCHOOL OR
GRADE SCHOOL /
COLLEGE /
GRADUATE SCHOOL /
VOCATIONAL
BUSINESS SCHOOL /
DO YOU POSSESS ANY OF THE FOLLOWING SKILLS? CHECK "YES" OR "NO".
DATA ENTRY YES NO LEGAL TERMINOLOGY YES NO TYPING YES NO
ELECTRONIC CALCULATOR YES NO MACHINE TRANSCRIPTION YES NO APPROXIMATE TYPING SPEED
WORD PROCESSING YES NO SHORTHAND YES NO
NOTE: IF YOU ARE APPLYING FOR A SECRETARIAL POSITION, YOU MUST CONTACT HUMAN RESOURCES AT 410-455-2337, TO SCHEDULE A TYPING TEST PRIOR TO THE CLOSING DATE OR YOUR APPLICATION WILL NOT BE CONSIDERED FURTHER FOR THE POSITION.
LIST ADDITIONAL SPECIAL QUALIFICATIONS AND SKILLS (OFFICE MACHINES/EQUIPMENT OPERATED, FOREIGN LANGUAGES SPOKEN, LABORATORY EQUIPMENT USED, COMPUTER SKILLS, ETC.)
IF THE POSITION YOU ARE APPLYING FOR REQUIRES A LICENSE (INCLUDING DRIVER'S LICENSE), CERTIFICATION
OR OTHER AUTHORIZATION TO PRACTICE A TRADE OR PROFESSION, COMPLETE THE FOLLOWING SECTION.
TYPE/CLASS / LICENSE NUMBER / STATE / GRANTED BY (BOARD OR COMMISSION) / EXPIRATION DATE
U.S. MILITARY SERVICE / TYPE OF DISCHARGE / DATE ENTERED / DATE OF DISCHARGE
IF YOUR ANSWER IS "YES" TO ANY OF THE FOLLOWING QUESTIONS, EXPLAIN IN BOX TO RIGHT
A. HAVE YOU EVER WORKED FOR THE UNIVERSITY YES NO
OR THE STATE OF MARYLAND?
B. HAVE YOU EVER BEEN CONVICTED OR FOUND GUILTY YES NO
IN COURT FOR OTHER THAN A MISDEMEANOR OR A
MINOR TRAFFIC VIOLATION?
C. HAVE YOU EVER INCURRED DISCIPLINARY ACTION AT YES NO
UMBC OR ANY OTHER INSTITUTION? / PLEASE LIST HOURS YOU ARE
AVAILABLE TO WORK
MONDAY
TUESDAY
WEDNESDAY
THURSDAY
FRIDAY
SATURDAY
BOOKSTORE HOURS M-TH 8:30 AM-7 PM
FRIDAY 8:30 AM–4 PM SATURDAY 10 AM–4 PM
YOUR FORMER EMPLOYER/SCHOOLS WILL BE USED AS REFERENCES. MAY WE CONTACT YOUR PRESENT EMPLOYER? YES NO
IF "NO", PLEASE EXPLAIN.
ADDITIONAL COMMENTS (FOR ADDITIONAL INFORMATION YOU WISH TO SUBMIT):
I CERTIFY THAT ALL INFORMATION ON THIS APPLICATION IS ACCURATE AND RECOGNIZE IT IS SUBJECT TO VERIFICATION AND THAT MY EMPLOYMENT AND/OR CONTINUANCE THEREOF MAY BE CONTINGENT UPON ITS ACCURACY. I UNDERSTAND THAT I MAY BE REQUIRED TO PASS A PHYSICAL EXAMINATION PRIOR TO FINAL ACCEPTANCE OF EMPLOYMENT. I ALSO UNDERSTAND THAT, IF HIRED, I WILL BE REQUIRED TO START AT THE BASE SALARY LEVEL UNLESS OTHERWISE STIPULATED OR PROVIDED BY UNIVERSITY PERSONNEL POLICY OR RULE.
BY APPLYING TO WORK AT THE BOOKSTORE, I UNDERSTAND THAT BOOKSTORE STAFF MAY BE VERIFYING THE INFORMATION I HAVE PROVIDED ON THIS APPLICATION, INCLUDING, BUT NOT LIMITED TO, CONFIRMATION OF ANY UNIVERSITY DISCIPLINARY FILE.
SIGNATURE OF APPLICANT DATE:
SIGNATURE OF APPLICANT DATE: